Children's Dental Emergencies | Mint Dental Team

CHILDREN’S DENTAL EMERGENCIES

Children’s dental emergencies and injuries are distressing for both the child and parent. Unfortunately, they’re also extremely common. In fact, one out of every three children experience some type of dental trauma or surgery. The most common “risk periods” are 18-40 months and pre-teen to teen, where environmental exploration and sports injuries occur, respectively. Below is a list of common dental emergencies and advice for dealing with them.

Toothache

A toothache is perhaps the most common ailment in children. This occurs when food is impacted into the tooth to cause fractures, decay, trauma, and wisdom tooth eruption. This can be treated preliminarily with brushing and regular teeth cleanings to avoid the problem. After the injury occurs, the site should be rinsed with warm water and the food found. Apply a cold compress to stop the swelling, then seek a dentist’s advice.

Dental avulsion (knocked-out tooth)

If a tooth has been knocked out of the child’s mouth completely, it is important to contact the dentist immediately. In general, dentists do not attempt to re-implant avulsed primary (baby) teeth, because the re-implantation procedure itself can cause damage to the tooth bud and thereby damage the emerging permanent tooth. A permanent tooth, however, can be easily re-implanted within the first hour (or longer if necessary) of the injury, when the trauma has not caused irreparable damage. To help, recover the tooth—but be careful to not touch the roots—and gently rinse/scrub it. In older children, re-insert the sanitized tooth into the socket gently or in the cheek pouch. Younger children should not do this in case they swallow it. Be sure to keep the tooth as moist as possible. Then seek medical attention immediately.

Dental intrusion (tooth pushed into jawbone)

Sometimes, dental trauma forces a tooth (or several teeth) upwards into the jawbone. The prognosis is better for teeth that have been pushed up to a lesser extent (less than 3mm), but every situation is unique. Oftentimes, the force of the trauma is great enough to injure the tooth’s ligament and fracture its socket. If dental intrusion of either the primary or permanent teeth is suspected, it is important to contact the dentist immediately. Depending on the nature and depth of the intrusion, the dentist will either wait for the tooth to descend naturally or perform root canal therapy to preserve the structure of the tooth. Rinse with cold water and place ice over the affected areas for swelling, use children’s Tylenol for the pain, and seek medical attention.

Tooth luxation/extrusion/lateral displacement (tooth displacement)

Tooth displacement is generally classified as “luxation,” “extrusion,” or “lateral displacement,” depending on the orientation of the tooth following trauma. A luxated tooth remains in the socket — with the pulp intact about half of the time. However, the tooth protrudes at an unnatural angle and the underlying jawbone is oftentimes fractured. The term “extrusion” refers to a tooth that has become partly removed from its socket. In young children, primary tooth extrusions tend to heal themselves without medical treatment. However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection.

Crown fracture

The crown is the largest, most visible part of the tooth. It is commonly the part of the tooth that sustains trauma. Crown fracture classifications range from minor enamel cracks (not an emergency) to pulp exposure (requiring immediate treatment). The dentist can readily assess the severity of the fracture using dental X-rays. Any change in tooth color (for example, pinkish or yellowish tinges inside the tooth) is an emergency warning sign. Minor crown fractures often warrant the application of dental sealant. More severe crown fractures sometimes require pulp treatments. Rinse the mouth with warm water and apply a cold compress, then utilize a strong pain reliever and proceed to seek medical attention.

Root fracture

A root fracture is caused by direct trauma and isn’t noticeable to the naked eye. If a root fracture is suspected, dental X-rays need to be taken. Depending on the exact positioning of the fracture and the child’s level of discomfort, the tooth can be monitored, treated, or extracted as a worst case scenario. Pain relievers and a cold compress should be applied and a dentist contacted.

Dental concussion

A tooth that has not been dislodged from its socket or fractured, but has received a bang or knock, can be described as “concussed.” Typically occurring in toddlers, dental concussion can cause the tooth to discolour permanently or temporarily. Unless the tooth turns black or dark (indicating that the tooth is dying and may require root canal therapy), dental concussion does not require emergency treatment.

Injured cheek, lip or tongue

If the child’s cheek, lip or tongue is bleeding due to an accidental cut or bite, apply firm direct pressure to the area using a clean cloth or gauze. Reduce swelling by applying ice to the affected areas. If the bleeding becomes uncontrollable, proceed to the Emergency Room or call a medical professional immediately.

Fractured jaw

If a broken or fractured jaw is suspected, proceed immediately to the Emergency Room. In the meantime, encourage the child not to move the jaw. In the case of a very young child, gently tie a scarf lengthways around the head and jaw to prevent movement.